Penile prosthesis implantation for the treatment for male erectile dysfunction: clinical outcomes and lessons learnt after 955 procedures.

PURPOSE: To evaluate the clinical outcomes of penile prosthesis implantation for the treatment for erectile dysfunction (ED) over 3 decades in a centre of excellence.

METHODS: A total of 955 penile prostheses were implanted between June 1981 and June 2010. The mean age of the men was 53.2 (28-80) years, and the mean follow-up was 76 (12-355) months. A total of 771 men had primary implants. The most common implant was Ultrex cylinder (54 %), and the main cause of ED was organic (32 %).

RESULTS: Primary implants showed higher rate of intra-operative complications than revision surgery (3.5 vs. 0.1 %) (p < 0.05). Prosthesis infection occurred in 0.8 % and equal incidence between diabetic and pelvic trauma patients. The average time to prosthetic revision was 102 (30-210) months. Kaplan-Meier estimates of overall penile prosthesis survival at 5 and 10 years were around 90.8 and 85.0 %. The most common mechanical failures were fluid loss (75 %). The majority of men were satisfied with the surgical outcomes, and 90 % of men would undergo penile prosthesis implant again.

CONCLUSIONS: Penile prosthesis surgery is a safe and durable treatment option for male ED. Strict adherence to antimicrobial prophylaxis and surgical practice is paramount to ensure low complication rates and high patient satisfaction rate.